Cover artwork by Central Station Design. The original album cover consisted of a montage of popular children's sweet wrappers. This was changed following objections from the U.S. manufacturers, resulting in the new, somewhat plainer album cover.[citation needed]

In November 2007, the album was re-released by Rhino records with extra tracks and a DVD of music videos.[citation needed]

In a contemporary review for The Village Voice, critic Robert Christgau cited "Grandbag's Funeral" and "Kinky Afro" as highlights and was more impressed by the band's rock music on the album: "their Voidoids is hotter than their 'dance music'".[6] He later gave it a two-star honorable mention, indicating a "likable effort that consumers attuned to its overriding aesthetic or individual vision may well enjoy."[2] In a less enthusiastic review, Bob Mack of Entertainment Weekly said that apart from "Step On" and "Donovan", the album shows that the band is less interesting than their Madchester contemporaries and do not warrant comparisons to the Rolling Stones.[3]Simon Reynolds, writing in The New York Times, called it a "perplexing mishmash" that can alienate listeners outside of Manchester's rave scene.[7]

In a retrospective review for Allmusic, Stephen Thomas Erlewine called Pills 'n' Thrills and Bellyaches a hedonistic album that was the peak of Happy Mondays' "career (and quite arguably the whole baggy/Madchester movement) ... a celebratory collage of sex, drugs, and dead-end jobs where there's no despair because only a sucker could think that this party would ever come to an end."[1]Q magazine called it their "artistic peak" and a "top-hole album".[4] In 2000, the magazine placed Pills 'n' Thrills and Bellyaches at number 31 in its list of the 100 Greatest British Albums Ever.[5] In 2005, the album was voted the 51st greatest album of all time by Channel 4 viewers.[citation needed]

The songs "Loose Fit" and "Kinky Afro" were featured in the 2002 film 24 Hour Party People, a dramatisation of the Manchester music scene during the time of the Happy Mondays, New Order & Joy Division.